Penicillin is the most common cause of anaphylaxis, for whatever reason, not just drug-induced cases. PENICILLIN, CEPHALOSPORIN, AND SULPHONAMIDE ANTIBIOTICS The patient is likewise able to ingest the incriminated food with impunity as long as no exercise occurs for several hours after eating the food. The individual is, however, able to exercise without symptoms, as long as the incriminated food is not consumed before exercise. Latex: banana, avocado, kiwifruit, chestnut and papayaįood-associated, exercise-induced anaphylaxis may occur when individuals exercise within 2-4 hours after ingesting a specific food.Ragweed pollen: melons (watermelon, cantaloupe, honeydew) and banana.Mugwort pollen: celery, apple, peanut and kiwifruit.Birch pollen: apple, raw potato, carrot, celery and hazelnut.Typical aero-allergen food cross-reactivities are: The main allergen of all grasses is profilin, which is a pan-allergen, found in many plants, pollens and fruits, and grass-sensitive individuals can sometimes react to many plant-derived foods. This is due to homologous allergens found between pollens and foods. Shellfish (shrimp, crab, lobster, oyster, scallops)įood sensitivity can be so severe that a systemic allergic reaction can occur to particle inhalation, such as the odors of cooked fish or the opening of a package of peanuts.Ī severe allergy to pollen, for example, ragweed, grass or tree pollen, can indicate that an individual may be susceptible to anaphylaxis or to the oral allergy syndrome (pollen/food syndrome) (manifested primarily by severe oropharyngeal itching, with or without facial angioedema) caused by eating certain plant-derived foods.Tree nuts (walnut, hazel nut/filbert, cashew, pistachio nut, Brazil nut, pine nut, almond).

Foods most frequently implicated in anaphylaxis are: In theory, any food glycoprotein is capable of causing an anaphylactic reaction. Death may occur within minutes but rarely has been reported to occur days to weeks after the initial anaphylactic event. Protracted anaphylaxis may occur, with symptoms persisting for days. There may occasionally be a quiescent period of 1–8 hours before the development of a second reaction (a biphasic response). Severe initial symptoms develop rapidly, reaching peak severity within 3-30 minutes. Genito-urinary: Uterine cramps, urinary urgency or incontinence. Ocular: Periorbital edema, erythema, conjunctival erythema, tearing. Respiratory: Upper airway obstruction from angioedema of the tongue, oropharynx or larynx bronchospasm, chest tightness, cough, wheezing rhinitis, sneezing, congestion, rhinorrhea.Ĭutaneous: Diffuse erythema, flushing, urticaria, pruritus, angioedema.Ĭardiovascular: Faintness, hypotension, arrhythmias, hypovolemic shock, syncope, chest pain. Oral: Pruritus of lips, tongue and palate, edema of lips and tongue. Gastro-intestinal: Abdominal pain, hyperperistalsis with faecal urgency or incontinence, nausea, vomiting, diarrhea. Patients often describe 'a sense of doom.' In this instance, the symptoms and signs of anaphylaxis are isolated to one organ system, but since anaphylaxis is a systemic event, in the vast majority of subjects two or more systems are involved. The initial manifestation of anaphylaxis may be loss of consciousness.

The clinical diagnosis and management are, however, identical. A second term, non-allergic anaphylaxis, describes clinically identical reactions that are not immunologically mediated. The term anaphylaxis is often reserved to describe immunological, especially IgE-mediated reactions. Most cases are mild but any anaphylaxis has the potential to become life-threatening.Īnaphylaxis develops rapidly, usually reaching peak severity within 5 to 30 minutes, and may, rarely, last for several days. It can be mild, moderate to severe, or severe. Anaphylaxis is defined by a number of signs and symptoms, alone or in combination, which occur within minutes, or up to a few hours, after exposure to a provoking agent. This disease summary is provided for informational purposes for physicians only.Īnaphylaxis is an acute, potentially life-threatening hypersensitivity reaction, involving the release of mediators from mast cells, basophils and recruited inflammatory cells. University of South Florida College of Medicine and the James A. Joy McCann Culverhouse Chair of Allergy and Immunology Professor of Medicine, Pediatrics and Public Healthĭirector of the Division of Allergy and Immunology Home: Education and Programs: Education: Allergic Disease Resource Center: Professionals: Anaphylaxis: Synopsis Anaphylaxis: Synopsis

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